Effects of inulin supplementation on inflammatory biomarkers and clinical symptoms of women with obesity and depression on a calorie-restricted diet: a randomized controlled clinical trial

Major depressive disorder (MDD) is regarded as an inflammatory disorder. Gut microbiota dysbiosis, observed in both MDD and obesity, leads to endotoxemia and inflammatory status, eventually exacerbating depressive symptoms. Manipulation of gut microbiota by prebiotics might help alleviate depression. The present study aimed to investigate the effects of inulin supplementation on psychological outcomes and biomarkers of gut permeability, endotoxemia, inflammation, and brain-derived neurotrophic factor (BDNF) in women with obesity and depression on a calorie-restricted diet. In a double-blind randomized clinical trial, 45 women with obesity and MDD were allocated to receive 10 g/day of either inulin or maltodextrin for eight weeks; all the patients followed a healthy calorie restricted diet, as well. Anthropometric measures, dietary intakes, depression, and serum levels of zonulin, lipopolysaccharide (LPS), inflammatory biomarkers (TNF-α, IL-10, MCP-1, TLR-4 and hs-CRP), and BDNF were assessed at baseline and end of the study. Weight and Hamilton depression rating scale (HDRS) scores decreased in both groups; between-group differences were non-significant by the end of study (P= 0.333 for body weight and P= 0.500 for HDRS). No between-group differences were observed for the other psychological outcomes and serum biomarkers (P>0.05). In this short-term study, prebiotic supplementation had no significant beneficial effects on depressive symptoms, gut permeability, or inflammatory biomarkers in women with obesity and depression.